BILL NUMBER: SB 308	CHAPTERED  07/22/99

	CHAPTER   149
	FILED WITH SECRETARY OF STATE   JULY 22, 1999
	APPROVED BY GOVERNOR   JULY 22, 1999
	PASSED THE ASSEMBLY   JULY 8, 1999
	PASSED THE SENATE   MAY 25, 1999
	AMENDED IN SENATE   MAY 17, 1999
	AMENDED IN SENATE   MAY 6, 1999

INTRODUCED BY   Senator Escutia

                        FEBRUARY 4, 1999

   An act to amend Section 2815.1 of the Business and Professions
Code, and to amend Sections 128230, 128280, 128330, 128335, 128345,
128350, 128355, 128375, 128385, 128395, 128400, 128435, 128445, and
128450 of, to amend the heading of Article 1 (commencing with Section
128330) of Chapter 5 of, to amend the heading of Chapter 5
(commencing with Section 128330) of, Part 5 of Division 107 of, and
to repeal Sections 128405 and 128455 of, the Health and Safety Code,
relating to nursing, and declaring the urgency thereof, to take
effect immediately.



	LEGISLATIVE COUNSEL'S DIGEST


   SB 308, Escutia.  Nurses.
   Existing law authorizes the Board of Registered Nursing to
establish fee schedules in connection with the issuance of licenses
for registered nurses, not to exceed certain amounts.  These
provisions authorize a biennial fee to be paid upon the filing of an
application for renewal of the license for registered nurses.
Existing law authorizes a separate additional $5 assessment at the
time of the biennial licensure renewal.  This latter provision is
repealed as of January 1, 2000.
   This bill would delete the repeal of the provisions authorizing
the imposition of the $5 separate assessment at the time of the
biennial licensure renewal, thereby extending that authority
indefinitely.
   Existing law requires the Office of Statewide Health Planning and
Development to establish the Minority Health Professions Education
Foundation and prescribes the powers of the foundation, to include
soliciting and receiving funds from various entities for the purpose
of providing financial assistance in the form of scholarships or
loans to students from various underrepresented minority groups, as
defined.
   Existing law establishes within the office a Minority Health
Professions Education Fund, a continuously appropriated fund, to
provide scholarships and loans to students from underrepresented
minority groups who are accepted to or enrolled in schools of
medicine, dentistry, nursing, or other health professions, and to
fund the Geriatric Nurse Practitioner and Clinical Nurse Specialist
Scholarship Program.  Existing law authorizes the foundation to
recommend to the director the disbursement of private sector moneys
deposited in the fund.
   This bill would rename the Minority Health Professions Education
Foundation and the Minority Health Professions Education Fund as the
Health Professions Education Foundation and the Health Professions
Education Fund, respectively.  The bill also would delete references
to "underrepresented minority groups" and refer instead to
"underrepresented groups," as defined, for these purposes.
   Existing law establishes within the Minority Health Professions
Education Foundation, the Registered Nurse Education Program which
provides procedures under which persons either from demographically
underrepresented groups or who agree in writing prior to graduation
to serve in an eligible county health facility or a health manpower
shortage area, as defined, may apply for awards under the program.
Existing law requires the foundation to solicit the advice of
representatives of certain organizations and entities in developing
the program.
   This bill would restrict participation in the program to persons
who agree in writing prior to graduation to serve in an eligible
county health facility or a health manpower shortage area.  The bill
would require the foundation to solicit the advice of representatives
who reflect the demographic diversity of California in developing
the program.
   Under existing law, the Registered Nurse Education Program and the
Geriatric Nurse Practitioner and Clinical Nurse Specialist
Scholarship Program would be repealed on January 1, 2000.
   This bill would delete those repeal dates, thereby extending those
programs indefinitely.
   This bill would declare that it is to take effect immediately as
an urgency statute.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  Section 2815.1 of the Business and Professions Code is
amended to read:
   2815.1.  As provided in subdivision (d) of Section 2815, the Board
of Registered Nursing shall collect an additional five dollar ($5)
assessment at the time of the biennial licensure renewal.  This
amount shall be credited to the Registered Nurse Education Fund.
This assessment is separate from those fees prescribed in Section
2815.
  SEC. 2.  Section 128230 of the Health and Safety Code is amended to
read:
   128230.  When making recommendations to the Director of the Office
of Statewide Health Planning and Development concerning the funding
of family practice programs or departments, family practice
residencies, and programs for the training of primary care physician
assistants and primary care nurse practitioners, the commission shall
give priority to programs that have demonstrated success in the
following areas:
   (a) Actual placement of individuals in medically underserved
areas.
   (b) Success in attracting and admitting members of minority groups
to the program.
   (c) Success in attracting and admitting individuals who were
former residents of medically underserved areas.
   (d) Location of the program in a medically underserved area.
   (e) The degree to which the program has agreed to accept
individuals with an obligation to repay loans awarded pursuant to the
Health Professions Education Fund.
  SEC. 3.  Section 128280 of the Health and Safety Code is amended to
read:
   128280.  Each publicly funded medical school in California shall
inform incoming medical students of all student loan, loan repayment,
and medical student scholarship programs available to them.  This
information shall include, but need not be limited to, information
concerning the National Health Service Corps program, the Health
Professions Education Foundation Program, and the Loan Assumption
Program created pursuant to this article.
  SEC. 4.  The heading of Chapter 5 (commencing with Section 128330)
of Division 107 of the Health and Safety Code is amended to read:
      CHAPTER 5.  HEALTH PROFESSIONS EDUCATION FOUNDATION PROGRAMS

  SEC. 5.  The heading of Article 1 (commencing with Section 128330)
of Chapter 5 of Division 107 of the Health and Safety Code is amended
to read:

      Article 1.  Health Professions Education Foundation

  SEC. 6.  Section 128330 of the Health and Safety Code is amended to
read:
   128330.  As used in this article:
   (a) "Board" means the Board of Trustees of the Health Professions
Education Foundation.
   (b) "Commission" means the Health Manpower Policy Commission.
   (c) "Director" means the Director of the Office of Statewide
Health Planning and Development.
   (d) "Foundation" means the Health Professions Education
Foundation.
   (e) "Health professions" or "health professionals" means
physicians and surgeons licensed pursuant to Chapter 5 (commencing
with Section 2000) of Division 2 of the Business and Professions
Code, dentists, registered nurses, and other health professionals
determined by the office to be needed in medically underserved areas.

   (f) "Office" means the Office of Statewide Health Planning and
Development.
   (g) "Underrepresented groups" means African-Americans, American
Indians, Hispanic-Americans, or other persons underrepresented in
medicine, dentistry, nursing, or other health professions as
determined by the board.  After January 1, 1990, the board, upon a
finding that the action is necessary to meet the health care needs of
medically underserved areas, may add a group comprising the
economically disadvantaged to those groups authorized to receive
assistance under this article.
  SEC. 7.  Section 128335 of the Health and Safety Code is amended to
read:
   128335.  (a) The office shall establish a nonprofit public benefit
corporation, to be known as the Health Professions Education
Foundation, that shall be governed by a board consisting of nine
members appointed by the Governor, one member appointed by the
Speaker of the Assembly, and one member appointed by the Senate
Committee on Rules.  The members of the foundation board appointed by
the Governor, Speaker of the Assembly, and Senate Committee on Rules
may include representatives of minority groups which are
underrepresented in the health professions, persons employed as
health professionals, and other appropriate members of health or
related professions.  All persons considered for appointment shall
have an interest in health programs, an interest in health
educational opportunities for underrepresented groups, and the
ability and desire to solicit funds for the purposes of this article
as determined by the appointing power.  The chairperson of the
commission shall also be a nonvoting, ex officio member of the board.

   (b) The Governor shall appoint the president of the board of
trustees from among those members appointed by the Governor, the
Speaker of the Assembly, and the Senate Committee on Rules.
   (c) The director, after consultation with the president of the
board, may appoint a council of advisers comprised of up to nine
members.  The council shall advise the director and the board on
technical matters and programmatic issues related to the Health
Professions Education Foundation Program.
   (d) Members of the board and members of the council shall serve
without compensation but shall be reimbursed for any actual and
necessary expenses incurred in connection with their duties as
members of the board or the council.
   (e) The foundation shall be subject to the Nonprofit Public
Benefit Corporation Law (Part 2 (commencing with Section 5110) of
Division 2 of Title 2 of the Corporations Code), except that if there
is a conflict with this article and the Nonprofit Public Benefit
Corporation Law (Part 2 (commencing with Section 5110) of Division 2
of Title 2 of the Corporations Code), this article shall prevail.
  SEC. 8.  Section 128345 of the Health and Safety Code is amended to
read:
   128345.  The Health Professions Education Foundation may do any of
the following:
   (a) Solicit and receive funds from business, industry,
foundations, and other private or public sources for the purpose of
providing financial assistance in the form of scholarships or loans
to African-American students, American Indian students,
Hispanic-American students, and other students from underrepresented
groups.  These funds shall be expended by the office after transfer
to the Health Professions Education Fund, created pursuant to Section
128355.
   (b) Recommend to the director the disbursement of private sector
moneys deposited in the Health Professions Education Fund to students
from underrepresented groups accepted to or enrolled in schools of
medicine, dentistry, nursing, or other health professions in the form
of loans or scholarships.
   (c) Recommend to the director a standard contractual agreement to
be signed by the director and any participating student, that would
require a period of obligated professional service in the areas in
California designated by the commission as deficient in primary care
services.  The agreement shall include a clause entitling the state
to recover the funds awarded plus the maximum allowable interest for
failure to begin or complete the service obligation.
   (d) Develop criteria for evaluating the likelihood that applicants
for scholarships or loans would remain to practice their profession
in designated areas deficient in primary care services.
   (e) Develop application forms, that shall be disseminated to
students from underrepresented groups interested in applying for
scholarships or loans.
   (f) Encourage private sector institutions, including hospitals,
community clinics, and other health agencies to identify and provide
educational experiences to students from underrepresented groups who
are potential applicants to schools of medicine, dentistry, nursing,
or other health professions.
   (g) Prepare and submit an annual report to the office documenting
the amount of money solicited from the private sector, the number of
scholarships and loans awarded, the enrollment levels of students
from underrepresented groups in schools of medicine, dentistry,
nursing, and other health professions, and the projected need for
scholarships and loans in the future.
   (h) Recommend to the director that a portion of the funds
solicited from the private sector be used for the administrative
requirements of the foundation.
  SEC. 9.  Section 128350 of the Health and Safety Code is amended to
read:
   128350.  The office shall do all of the following:
   (a) Provide technical and staff support to the foundation in
meeting all of its responsibilities.
   (b) Provide financial management for the Health Professions
Education Fund.
   (c) Enter into contractual agreements with students from
underrepresented groups for the disbursement of scholarships or loans
in return for the commitment of these students to practice their
profession in an area in California designated as deficient in
primary care services.
   (d) Disseminate information regarding the areas in the state that
are deficient in primary care services to potential applicants for
the scholarships or loans.
   (e) Monitor the practice locations of the recipients of the
scholarships or loans.
   (f) Recover funds, in accordance with the terms of the contractual
agreements, from recipients of scholarships or loans who fail to
begin or complete their obligated service.  Funds so recovered shall
be redeposited in the Health Professions Education Fund.
   (g) Contract with the institutions that train family practice
residents, in order to increase the participation of students from
underrepresented groups in entering the specialty of family practice.
  The director may seek the recommendations of the commission or
foundation as to what programs best demonstrate the ability to meet
this objective.
   (h) Contract with training institutions that are involved in
osteopathic postgraduate training in general or family practice
medicine, in order to increase the participation of students from
underrepresented groups participating in the practice of osteopathic
medicine.  The director may seek the recommendations of the
commission or foundation as to what programs have demonstrated the
ability to meet this objective.
   (i) Enter into contractual agreements with graduated health
professionals to repay some or all of the debts they incurred in
health professional schools in return for practicing their
professions in an area in California designated as deficient in
primary care services.
   (j) Contract with institutions that award baccalaureate of science
degrees in nursing in order to increase the participation of
students from underrepresented groups in the nursing profession.  The
director may seek the recommendations of the commission as to what
programs have demonstrated the ability to meet this objective.
  SEC. 10.  Section 128355 of the Health and Safety Code is amended
to read:
   128355.  There is hereby created within the office a Health
Professions Education Fund.  The primary purpose of this fund is to
provide scholarships and loans to students from underrepresented
groups who are accepted to or enrolled in schools of medicine,
dentistry, nursing, or other health professions, and to fund the
Geriatric Nurse Practitioner and Clinical Nurse Specialist
Scholarship Program pursuant to Article 3 (commencing with Section
128425).  The fund shall also be used to pay for the cost of
administering the program and for any other purpose authorized by
this article.  The level of expenditure by the office for the
administrative support of the program created pursuant to this
article shall be subject to review and approval annually through the
State Budget process.  The office may receive private donations to be
deposited into this fund.  All money in the fund is continuously
appropriated to the office for the purposes of this article and
Article 3 (commencing with Section 128425).  The office shall manage
this fund prudently in accordance with other provisions of law.
  SEC. 11.  Section 128375 of the Health and Safety Code is amended
to read:
   128375.  (a) The Legislature hereby finds and declares that an
adequate supply of professional nurses is critical to assuring the
health and well-being of the citizens of California, particularly
those who live in medically underserved areas.
   (b) The Legislature further finds that changes in the health care
system of this state have increased the need for more highly skilled
nurses.  These changes include advances in medical technology and
pharmacology, that necessitate the use of more highly skilled nurses
in acute care facilities.  Further, the containment of health care
costs has led to increased reliance on home health care and
outpatient services and to a higher proportion of more acutely ill
patients in acute care facilities.  Long-term care facilities also
need more highly educated nursing personnel.  Both shifts require a
larger number of skilled nursing personnel.
   (c) The Legislature further finds and declares that in nursing, as
in other professions, certain populations are underrepresented.  The
Legislature also finds and declares that it is especially important
that nursing care be provided in a way that is sensitive to the
sociocultural variables that affect a person's health.  The
Legislature recognizes that the financial burden of obtaining a
baccalaureate degree is considerable and that persons from families
lacking adequate financial resources may need financial assistance to
complete a baccalaureate degree.
   (d) The Legislature further finds and declares that approximately
54.1 percent of all Californians live in rural and urban areas that
have been designated underserved.  The shortage of professional
nurses in these areas makes it more difficult for those citizens to
obtain health care and more difficult to attract and retain other
health care professionals to those areas.
   (e) The Legislature further finds and declares that since July 1,
1989, the Registered Nurse Education Fund has collected five million
two hundred eight thousand five hundred seventy-four dollars
($5,208,574) to support the education of professional nurses and
nursing students in California.
   (f) The Legislature further finds and declares that since 1990,
the Health Professions Education Foundation has awarded over four
million dollars ($4,000,000) in scholarship and loan repayment to 754
nursing students and nurses in California.
   (g) The Legislature further finds and declares that 107 award
recipients are baccalaureate of science degree prepared nurses who
have made a commitment to practice in medically underserved areas of
California for a period of two years in exchange for loan repayment.

   (h) The Legislature further finds that 485 of the award recipients
are baccalaureate of science degree nursing students.  Since 1990,
199 nurses have completed their contractual obligation with the
Office of Statewide Planning and Development.
   (i) The Legislature further finds and declares that, since 1994,
112 associate degree nursing scholarship awards have been made to
students who have signed a contract with the office to complete a
baccalaureate of science degree within five years of completing their
associate degree.  Six students have completed the articulations
pilot program.
   (j) The Legislature further finds that recipients of the
foundation's financial assistance program have come from very diverse
backgrounds.  Scholarships have been awarded to African-Americans,
American Indians, Asian-Pacific Islanders, Caucasians,
Hispanic-Americans, and other individuals.
  SEC. 12.  Section 128385 of the Health and Safety Code is amended
to read:
   128385.  (a) There is hereby created the Registered Nurse
Education Program within the Health Professions Education Foundation.
  Persons participating in this program shall be persons who agree in
writing prior to graduation to serve in an eligible county health
facility or a health manpower shortage area, as designated by the
director of the office.  Persons agreeing to serve in eligible county
health facilities or health manpower shortage areas may apply for
scholarship or loan repayment.  The Registered Nurse Education
Program shall be administered in accordance with Article 1
(commencing with Section 128330), except that all funds in the
Registered Nurse Education Fund shall be used only for the purpose of
promoting the education of registered nurses and related
administrative costs.  The Health Professions Education Foundation
shall make recommendations to the director of the office concerning
both the following:
   (1) A standard contractual agreement to be signed by the director
and any student who has received an award to work in an eligible
county health facility or in a health manpower shortage area that
would require a period of obligated professional service in the areas
of California designated by the Health Manpower Policy Commission as
deficient in primary care services.  The obligated professional
service shall be in direct patient care.  The agreement shall include
a clause entitling the state to recover the funds awarded plus the
maximum allowable interest for failure to begin or complete the
service obligation.
   (2) Maximum allowable amounts for scholarships, educational loans,
and loan repayment programs in order to assure the most effective
use of these funds.
   (b) Applicants may be persons licensed as registered nurses or
graduates of associate degree nursing programs prior to entering a
program granting a baccalaureate of science degree in nursing.
Priority shall be given to applicants who hold associate degrees in
nursing.
   (c) Not more than 5 percent of the funds available under the
Registered Nurse Education Program shall be available for a pilot
project designed to test whether it is possible to encourage
articulation from associate degree nursing programs to baccalaureate
of science degree nursing programs.  Persons who otherwise meet the
standards of subdivision (a) shall be eligible for educational loans
when they are enrolled in associate degree nursing programs.  If
these persons complete a baccalaureate of science degree nursing
program in California within five years of obtaining an associate
degree in nursing and meet the standards of this article, these loans
shall be completely forgiven.
   (d) As used in this section, "eligible county health facility"
means a county health facility that has been determined by the office
to have a nursing vacancy rate greater than noncounty health
facilities located in the same health facility planning area.
  SEC. 13.  Section 128395 of the Health and Safety Code is amended
to read:
   128395.  In developing this program, the Health Professions
Education Foundation shall solicit the advice of representatives of
the Board of Registered Nurses, the California Nurses Association and
other professional nurse organizations, the Chancellor of the
California Community Colleges, the Chancellor of the California State
University, and the California Association of Hospitals and Health
Systems.  The foundation shall solicit the advice of representatives
who reflect the demographic diversity of California.
  SEC. 14.  Section 128400 of the Health and Safety Code is amended
to read:
   128400.  There is hereby established in the State Treasury the
Registered Nurse Education Fund.  All money in the fund shall be used
for the purposes specified in the California Registered Nurse
Education Program established pursuant to this article.  This fund
shall receive money collected pursuant to subdivision (c) of Section
2815 of the Business and Professions Code.
  SEC. 15.  Section 128405 of the Health and Safety Code is repealed.

  SEC. 16.  Section 128435 of the Health and Safety Code is amended
to read:
   128435.  (a) There is hereby created the Geriatric Nurse
Practitioner and Clinical Nurse Specialist Scholarship Program within
the Health Professions Education Foundation.  Persons participating
in this program shall be persons enrolled in nurse practitioner or
clinical nurse specialist programs in this state who agree in writing
prior to graduation to practice for a period of time, to be
determined in accordance with paragraph (1) of subdivision (b), as
geriatric nurse practitioners or geriatric clinical nurse specialists
either in skilled nursing facilities licensed pursuant to Section
1250 or in other settings where care is provided primarily to
geriatric patients.  This program shall be administered in accordance
with Article 1 (commencing with Section 128330), and Article 2
(commencing with Section 128375), except that all funds shall be used
only for geriatric nurse practitioners and geriatric clinical nurse
specialists and except that the programs shall be available only to
those geriatric nurse practitioners and geriatric clinical nurse
specialists who agree to practice in skilled nursing facilities or
other settings caring for geriatric patients.
   (b) The Health Professions Education Foundation shall make
recommendations to the director of the office concerning both of the
following:
   (1) A standard contractual agreement to be signed by the director
and any student who has received an award to practice in a skilled
nursing facility or other setting caring for geriatric patients that
would require a period of obligated professional service.  The
obligated professional service shall be in direct patient care.  The
obligated professional service may be performed by a geriatric nurse
practitioner or geriatric clinical nurse specialist either as an
employee or independent contractor of a skilled nursing facility or
other setting caring for geriatric patients, or as an employee or
independent contractor of a physician providing care for geriatric
patients in a skilled nursing facility or other setting. The
agreement shall include a clause entitling the state to recover the
funds awarded plus the maximum allowable interest for failure to
begin or complete the service obligation.
   (2) Maximum allowable amounts for scholarships and other financial
assistance in order to assure the most effective use of these funds.

   (c) To the extent feasible and appropriate, the Health Professions
Education Foundation shall assure that the standard contractual
agreement and other aspects of the Geriatric Nurse Practitioner and
Clinical Nurse Specialist Scholarship Program are substantially
similar to those developed for the Registered Nurse Education
Program.
  SEC. 17.  Section 128445 of the Health and Safety Code is amended
to read:
   128445.  In developing this program, the Health Professions
Education Foundation shall solicit the advice of the representatives
of the Board of Registered Nursing, the Student Aid Commission, the
California Nurses Association, the California Association of Health
Facilities, the California Association of Homes for the Aging, the
Chancellor of the California State University, the President of the
University of California, and other entities as may be appropriate.

  SEC. 18.  Section 128450 of the Health and Safety Code is amended
to read:
   128450.  This program shall be funded through the Health
Professions Education Fund pursuant to Section 128355.
  SEC. 19.  Section 128455 of the Health and Safety Code is repealed.

  SEC. 20.  This act is an urgency statute necessary for the
immediate preservation of the public peace, health, or safety within
the meaning of Article IV of the Constitution and shall go into
immediate effect.  The facts constituting the necessity are:
   In order to ensure that vital scholarship funding may be
distributed to students who will pursue degrees in health education
during the 1999-2000 fiscal year, it is necessary that this act take
effect immediately.
